山东大学耳鼻喉眼学报

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中药冲洗对鼻黏膜纤毛超微结构的影响

李学昌, 王金磊, 张玉莉, 董文汇, 韩在文   

  1. 潍坊市人民医院耳鼻咽喉科, 山东 潍坊 261041
  • 收稿日期:2005-09-20 修回日期:1900-01-01 出版日期:2006-12-24 发布日期:2006-12-24
  • 通讯作者: 李学昌

LI Xue-chang, WANG Jin-lei, ZHANG Yu-li, DONG Wen-hui, HAN Zai-wen   

  1. Department of Otorhinolaryngology, Weifang People′s Hospital, Weifang 261041, Shandong, China
  • Received:2005-09-20 Revised:1900-01-01 Online:2006-12-24 Published:2006-12-24
  • Contact: LI Xue-chang

摘要: 目的:观察慢性鼻-鼻窦炎患者在鼻内窥镜术后应用鼻窦炎口服液冲洗鼻腔,对鼻黏膜纤毛超微结构的影响。方法:对30例接受ESS的慢性鼻-鼻窦炎患者,术后分A、B、C三组用不同方法处理,对各组患者分别于术前、术后3个月取上颌窦口周围黏膜进行电镜观察,另取2例作为健康对照。结果:术前各组黏膜上皮纤毛脱落,排列紊乱,间质水肿,可见中性粒细胞及杯状细胞。线粒体减少,明显肿胀,出现空泡。纤毛融合,微管结构异常;术后A、B组纤毛排列较整齐,粗细亦均匀,方向较一致,且纤毛丰富、密集,“9+2”微管结构清晰,线粒体狭长致密,与健康对照组结构无明显差异;术后C组可见纤毛数量明显增多,排列尚整齐,方向欠统一,并可见大量短纤毛,线粒体仍肿胀,仍可见病理性改变。结论:鼻内镜手术后应用鼻窦炎口服液冲洗能促进鼻黏膜纤毛结构的恢复。

关键词: 外科手术, 内窥镜, 鼻窦炎, 鼻黏膜, 鼻腔

Abstract: To observe the infl uence of irrigation at nasal cavity with Bidouyan oral liquid on the ultrastructure of nasal mucocilia after endoscopic sinus surgery(ESS) in patients with chronic rhinosinusitis. Methods: Thirty patients with chronic rhinosinusitis were dealt with endoscopic sinus surgery and then divided into three groups at random. Group A: 500?ml physiologic saline adding 20?ml Bidouyan oral liquid was applied for nasal cavity irrigation for 3 days to 3 months after ESS, twice each week. Group B: 500?ml physiologic saline adding 80?000?U gentamycin and 5?mg dexamethasone solution was applied for nasal cavity irrigation after ESS, twice each week. Group C: 500?ml physiologic saline alone was applied for nasal cavity irrigation after surgery. All the patients accepted saccharin test before surgery and three months after surgery, and 2 healthy cases were observed as controls. Results: The mucosa was examined with electron microscope before surgery and three months after surgery. After surgery, the cilia arranged in order and densely, and the structure of “9+2" canaliculus was normal. Conclusion: Irrigation at nasal cavity with Bidouyan oral liquid after surgery can accelerate the recovering of nasal mucosa.

Key words: endoscopy, Surgical procedures, Sinusitis, Nasal mucosa, Nasal cavity

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